Kimberly Jo Tuttle, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

495 N Main St
Canandaigua, NY 14424-1283

Phone

(585) 393-3515

Fax

(585) 393-3515

NPI assigned

Jul 16, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kimberly Jo Willis Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western New York Medical Practice P.C.

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1063790608
  Medicare reassignment NPD
• Clifton Springs Sanitarium Co

  dba Clifton Springs Hospital and Clinic

  • General Acute Care Hospital
  • Clifton Springs, NY
  • NPI 1366505463
  Medicare reassignment
• Midtown East Medical Services, PC

  • Nurse Practitioner
  • Pittsford, NY
  • NPI 1801292800
  Medicare reassignment
• Rochester General Hospital

  dba Rochester General Medical Groups

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1356412712
  Medicare reassignment
• The Unity Hospital of Rochester

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1760421713
  Medicare reassignment
• Wellnow Urgent Care, PC

  dba WellNow Urgent Care

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1669825162
  Medicare reassignment
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1255360517
  NPD
• Rochester General Hospital

  • Multi-Specialty Clinic/Center
  • Rochester, NY
  • NPI 1861568594
  NPD
• The Unity Hospital of Rochester

  dba Unity Physician Services

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1457395766
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1558560995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 N MAIN ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241283",
            "telephone_number": "585-393-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N MAIN ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241283",
            "telephone_number": "585-393-3515",
            "fax_number": "585-393-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTLE",
        "first_name": "KIMBERLY",
        "middle_name": "JO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-16",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03385908",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WILLIS",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alyssa Troutner
• Jeffrey Saunders Trumbull, RPA-C
• Salome Tsige, LPC
• Brittney Tucker, MS, OTR/L
• Virginia Sue Tully, NP
• Whitney Tyler, MS, OTR/L
• Sean Michael Tyrell, DPT
• Chantel Underwood
• University Orthopaedic Associates of Rochester
• Ryan Peter Urban

• Medical Physician Assistant in Canandaigua, NY
• Providers in Canandaigua, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.